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Bacteremia with ESBL-producing Enterobacterales is associated with IgG antibodies reacting with CTX-M-15 and/or CTX-M-27

Sahlström, Thomas LU orcid ; Ljungquist, Oskar LU ; Su, Yu Ching LU ; Resman, Fredrik LU ; Mattsson, Emma LU ; Tham, Johan LU and Riesbeck, Kristian LU orcid (2020) In International Journal of Medical Microbiology 310(8).
Abstract

Objectives: The adaptive humoral immune response following clinical infection with extended spectrum beta-lactamase (ESBL)-producing Enterobacterales (EPE) has not been thoroughly investigated. The aim of this study was to investigate the presence of anti-CTX-M-15 and/or anti-CTX-M-27 IgG antibodies in bacteremia patients diagnosed with EPE compared to a control group consisting of patients suffering from bacteremia with third generation cephalosporin-susceptible Escherichia coli (3GCSE). Methods: Patientswith EPE (n = 59) or 3GCSE (n = 42) bacteremia were recruited in this case control study in the Skåne County (South of Sweden). Sera were collected 1–26 months after bacteremia. Enzyme-linked immunosorbent assay (ELISA) was used for... (More)

Objectives: The adaptive humoral immune response following clinical infection with extended spectrum beta-lactamase (ESBL)-producing Enterobacterales (EPE) has not been thoroughly investigated. The aim of this study was to investigate the presence of anti-CTX-M-15 and/or anti-CTX-M-27 IgG antibodies in bacteremia patients diagnosed with EPE compared to a control group consisting of patients suffering from bacteremia with third generation cephalosporin-susceptible Escherichia coli (3GCSE). Methods: Patientswith EPE (n = 59) or 3GCSE (n = 42) bacteremia were recruited in this case control study in the Skåne County (South of Sweden). Sera were collected 1–26 months after bacteremia. Enzyme-linked immunosorbent assay (ELISA) was used for detection of specific IgG antibodies directed against recombinant beta-lactamases CTX-M-15 and CTX-M-27. The beta-lactamase resistance genes of the corresponding EPE blood isolates were determined by DNA sequencing. Results: The majority (n = 47; 80 %) of the 59 EPE blood isolates carried blaCTX-M-15 or blaCTX-M-27 genes. IgG antibodies reacting to the corresponding CTX-M enzyme was seen in 28 % (13/47) of patients suffering from EPE-bacteremia, while antibodies were detected in only 9.5 % (4/42) of patients with 3GCSE (p = 0.03). Patients with EPE had a statistically significantly higher median Charlson comorbidity index and prevalence of renal disease (p = 0.01), compared to the 3GCSE control group. Conclusion: This study implies that EPE bacteremia can trigger production of IgG antibodies targeting ESBL. Further investigations are required to determine the functional role of anti-ESBL antibodies against EPE bacteremia.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antimicrobial resistance, Beta-Lactamases, CTX, Escherichia coli, Immune response, Immunoglobulin
in
International Journal of Medical Microbiology
volume
310
issue
8
article number
151468
publisher
Elsevier
external identifiers
  • pmid:33307382
  • scopus:85097714123
ISSN
1438-4221
DOI
10.1016/j.ijmm.2020.151468
project
Antimicrobial resistance and sepsis
language
English
LU publication?
yes
id
1ad390fd-71ac-45f3-b7ff-657e9ddb7a9a
date added to LUP
2021-01-05 14:44:38
date last changed
2025-10-14 13:00:40
@article{1ad390fd-71ac-45f3-b7ff-657e9ddb7a9a,
  abstract     = {{<p>Objectives: The adaptive humoral immune response following clinical infection with extended spectrum beta-lactamase (ESBL)-producing Enterobacterales (EPE) has not been thoroughly investigated. The aim of this study was to investigate the presence of anti-CTX-M-15 and/or anti-CTX-M-27 IgG antibodies in bacteremia patients diagnosed with EPE compared to a control group consisting of patients suffering from bacteremia with third generation cephalosporin-susceptible Escherichia coli (3GCSE). Methods: Patientswith EPE (n = 59) or 3GCSE (n = 42) bacteremia were recruited in this case control study in the Skåne County (South of Sweden). Sera were collected 1–26 months after bacteremia. Enzyme-linked immunosorbent assay (ELISA) was used for detection of specific IgG antibodies directed against recombinant beta-lactamases CTX-M-15 and CTX-M-27. The beta-lactamase resistance genes of the corresponding EPE blood isolates were determined by DNA sequencing. Results: The majority (n = 47; 80 %) of the 59 EPE blood isolates carried bla<sub>CTX-M-15</sub> or bla<sub>CTX-M-27</sub> genes. IgG antibodies reacting to the corresponding CTX-M enzyme was seen in 28 % (13/47) of patients suffering from EPE-bacteremia, while antibodies were detected in only 9.5 % (4/42) of patients with 3GCSE (p = 0.03). Patients with EPE had a statistically significantly higher median Charlson comorbidity index and prevalence of renal disease (p = 0.01), compared to the 3GCSE control group. Conclusion: This study implies that EPE bacteremia can trigger production of IgG antibodies targeting ESBL. Further investigations are required to determine the functional role of anti-ESBL antibodies against EPE bacteremia.</p>}},
  author       = {{Sahlström, Thomas and Ljungquist, Oskar and Su, Yu Ching and Resman, Fredrik and Mattsson, Emma and Tham, Johan and Riesbeck, Kristian}},
  issn         = {{1438-4221}},
  keywords     = {{Antimicrobial resistance; Beta-Lactamases; CTX; Escherichia coli; Immune response; Immunoglobulin}},
  language     = {{eng}},
  number       = {{8}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Medical Microbiology}},
  title        = {{Bacteremia with ESBL-producing Enterobacterales is associated with IgG antibodies reacting with CTX-M-15 and/or CTX-M-27}},
  url          = {{http://dx.doi.org/10.1016/j.ijmm.2020.151468}},
  doi          = {{10.1016/j.ijmm.2020.151468}},
  volume       = {{310}},
  year         = {{2020}},
}